| Popis: |
Background Complex abdominal wall defects are important conditions with a high morbidity, leading to impairment of patients physical condition and quality of life. In the last decade, the abdominal wall reconstruction paradigm has changed due to formation of experienced and excellence groups, improving clinical outcomes after surgery. Therefore, our study shows the perspective and outcomes of an abdominal wall reconstruction group (AWRG) in Colombia, focused on transverse abdominis release (TAR) procedure. Methods A retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent TAR procedure between January 2014 – December 2020 were included. Analysis and description of postoperative outcomes (recurrence, surgical site infection (SSI), seroma, hematoma, and re-intervention) was performed. Results 50 patients underwent TAR procedure. 62% of patients were male. Mean age was 55 ± 13.4 years. Mean BMI was 27.8 ± 4.5 Kg/m2. Abdominal wall defects were classified with EHS ventral Hernia classification having a W3 hernia in 72% of all defects (Mean gap size of 11.49 cm ± 4.03 cm). Mean CeDAR preoperative risk score was 20.5% ± 14.5%. Protective association was established for SSI if the procedure was performed by the AWRG OR 0.7 (IC 95% 0.05–0.93). Higher risk of SSI was found in cases not performed by the abdominal wall reconstruction group OR 13.6 (CI 95% 9.12–15.5). In terms of hernia relapse, we have 12% of cases; all of them over a year after the surgery. Conclusions TAR procedure for complex abdominal wall defects under specific clinical conditions including emergency scenarios is viable. Specialized and experienced groups show lessen surgical site occurrences; further studies are needed to confirm our results. |
